Abstract To evaluate and report outcomes of patients who underwent ablative radiation segmentectomy (RS) for the primary treatment of early-stage hepatocellular carcinoma (HCC). A retrospective, single-center analysis of treatment-naïve HCC patients (n = 343) who underwent 90Yttrium RS with glass microspheres (TheraSphere Boston Scientific, Marlborough, Massachusetts, United States) from January 2018 to December 2023 was performed. Patients were stratified utilizing the same inclusion criteria as benchmark studies, LEGACY (treatment-naïve, solitary HCC ≤ 8 cm), Barcelona Clinic Liver Cancer (BCLC) stage A, Child-Pugh A, and Eastern Cooperative Oncology Group (ECOG) scores 0–1, n = 112) and RASER (treatment-naïve, resection ineligible, nonablatable, solitary HCC ≤ 3 cm, BCLC-A, Child-Pugh A-B7, and ECOG 0, n = 39). Comparative outcome measures included target objective response rate (tORR), overall objective response rate, target duration of response, target time to progression, overall time to progression (oTTP), and overall survival (OS). Of the 112 patients that met LEGACY inclusion criteria, matched-cohort OS closely approximated LEGACY at 42-months (80% vs. 75%). Similar OS outcomes were noted in patients stratified based on treatment track in transplant (93% vs. 93%) and primary (73% vs. 75%) treatment pathways. Patients with tORR had a 98% durable response at 6-months, eclipsing the LEGACY benchmark of 76%. In 39 patients who met RASER inclusion criteria, oTTP outcomes were similar or slightly improved in the matched-cohort at both 12- and 24-months (95% vs. 86% and 80% vs. 73%, respectively). The results of this matched-cohort analysis highlight the reproducibility of LEGACY and RASER outcomes with ablative RS.
Gimenez et al. (Mon,) studied this question.
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